NON-SURGICAL TREATMENT OPTIONS

​

Many patients benefit from non-surgical measures first, either as a complete solution or as a foundation alongside further treatment:

 

• Nasal sprays — a steroid nasal spray reduces nasal congestion that contributes to mouth-breathing and snoring, though on its own it doesn't address obstruction at the palate or tongue base

• Positional therapy — for patients whose obstruction is significantly worse lying on their back, a positional aid such as a specially designed pillow or wearable positional trainer encourages side-sleeping and can meaningfully reduce symptoms

• Mandibular advancement device (MAD) — a custom-fitted, gum-shield-like device worn at night that gently brings the lower jaw forward, opening the airway behind the tongue. This is a well established treatment for simple snoring and mild-to-moderate OSA, though some patients find it uncomfortable, or notice tooth movement or jaw ache with long-term use

• CPAP — for many patients with moderate-to-severe OSA, a CPAP machine remains the standard first-line treatment. Surgery is considered where CPAP isn't tolerated, or alongside it to improve tolerance

​

 

SURGICAL TREATMENT OPTIONS

​

Where non-surgical measures aren't enough, or aren't tolerated, surgery is tailored to the site of obstruction identified during your assessment. People with moderate to severe OSA often suffer from multilevel airway obstruction (blockage of the airway at more than one site). Therefore multilevel airway surgery is sometimes needed to treat severe disease. Mr Dale offers:

​

• Nasal surgery (septoplasty and turbinate reduction) — to improve airflow through the nose. On its own this rarely resolves OSA if other levels of the airway are also involved; see the Nasal Blockage page for more details.

• Expansion sphincter pharyngoplasty with palate advancement — a refined form of uvulopalatopharyngoplasty (UPPP) that repositions and tightens the muscles of the soft palate and the side walls of the throat, opening the airway rather than simply removing tissue. This modified technique is associated with fewer long term side effects than older UPPP approaches

• Radiofrequency ablation or coblation of the tongue — a minimally invasive procedure using gentle heat energy to stiffen and reduce the volume of tissue within the tongue, drawing it forwards off the back wall of the throat. This aims to treat airway obstruction at the level of the tongue base with a comparatively straightforward recovery

​​​

​

WHICH TREATMENT IS RIGHT FOR YOU?

 

There's no single operation, or single device, that suits everyone — the right combination depends on where your airway is obstructed, how severe your OSA is, and what you've already tried. After a thorough assessment, Mr Dale will set out an individual view of what's likely to help, rather than a one-size-fits-all recommendation.

 

 

RECOVERY

 

Recovery depends on which treatment is used. Non-surgical options such as a MAD or positional therapy involve no recovery time at all. Nasal surgery, modified UPPP and tongue base radiofrequency ablation each have different recovery profiles — in general, most patients are back to normal light activity within 1-2 weeks, with palate and tongue base procedures typically taking a little longer to settle than nasal surgery alone.

 

 

RISKS AND REALISTIC EXPECTATIONS

 

Each procedure carries its own specific risks, including bleeding, infection, and — for palate and tongue base surgery — temporary discomfort on swallowing, all of which Mr Dale will discuss in full for your particular treatment plan. More generally, treatment for OSA improves, but does not always completely eliminate, symptoms, particularly in more severe or multi-level cases. Mr Dale will give you a realistic, individual view of expected improvement based on your assessment.

 

 

FEES

 

Fees depend entirely on which treatment, or combination, is required following your assessment. An initial appointment is £275-£300 and most people will need a nasal endoscopy (£285) to fully asses the airway. A sleep study, if needed, typically costs in the region of £250-£450. A mandibular advancement device can be purchased for around £150 for an off the shelf model, or £400-£800 for a custom fitted device. Surgical fees are quoted individually once a treatment plan is agreed. A full itemised quote is provided before you commit to any surgery.

 

​

TRAVELLING FOR TREATMENT

 

Many patients seeking a clear, structured route through OSA assessment travel from outside Bristol, particularly where local pathways have been slow or inconclusive. The Spire Hospital, Bristol is well served by the M4/M5 and direct trains to Temple Meads from London, Cardiff, and the Midlands.

 

FREQUENTLY ASKED QUESTIONS

​

Will treatment cure my sleep apnoea completely?

It depends on severity and the site(s) of obstruction — many patients see significant improvement in their symptoms and the severity of their sleep apnoea following surgery. Some no longer need to use a CPAP machine, in other cases CPAP may still be required after surgery. The success of treatment depends upon a number of factors, and the likely outcomes will be discussed in detail at your appointment. 

​

I can't tolerate my CPAP machine — what are my options?

A mandibular advancement device, positional therapy, or surgery may all be appropriate depending on your anatomy and the severity of your OSA. An assessment will clarify which is the best fit for you.

 

Do you offer hypoglossal nerve stimulation (Inspire)?

No — this isn't currently part of Mr Dale's practice. Where it may be a relevant option for your case, this will be discussed openly at consultation, along with how to access it.

 

Do I need a sleep study before seeing you?

Not necessarily — if you don't already have one, this can be arranged as part of your assessment.

 

Is snoring surgery the same as sleep apnoea surgery?

They can overlap, but simple snoring and diagnosed OSA are assessed differently, and the surgical threshold and choice of procedure depend on which you have.

​